Medical Billing Specialist

Schedule

Full-time, 80 hours per pay period; Monday – Friday, 8:00 am – 4:30 pm. Position is on‑site daily (no remote work). No weekend or holiday rotation.

About the role

The Medical Billing Specialist is responsible for accurately preparing, submitting, and following up on medical claims to insurance companies and patients. This role ensures timely reimbursement, compliance with healthcare regulations, and effective communication with providers, payers, and patients.

Responsibilities

• Prepare, submit, and transmit clean medical claims to commercial, Medicare, and Medicaid payers (electronic and paper).
• Review and resolve accounts and pre‑claim edits.
• Verify patient insurance coverage and benefits.
• Review documentation and charges for accuracy and compliance.
• Monitor accounts receivable and follow up on outstanding balances.
• Follow up on unpaid, denied, or rejected claims and resolve billing issues.
• Review and reconcile account credit balances.
• Identify and correct billing errors to prevent claim rejections.
• Communicate and collaborate with coding, denial‑management specialists, insurance companies, patients, clinical staff, and healthcare providers regarding billing inquiries or issues.
• Maintain compliance with HIPAA, Medicare, Medicaid, and payer guidelines.
• Assist with patient billing questions and patient payments.
• Interpret EOBs and remittance advice.
• Maintain accurate billing records and documentation.
• Support audits and compliance initiatives when documentation is required.
• Perform other duties as requested.

Requirements

• High school diploma or equivalent (required).
• 1+ years of related work experience (required).
• Experience working in the medical industry (preferred).
• Familiarity with insurance guidelines, EOBs, and claim adjudication processes.
• Proficiency with electronic health records (EHR) and billing software.
• Exceptional accuracy and attention to detail.

Knowledge, Skills, & Abilities

• Intermediate proficiency with computers.
• Experience in insurance claims processing.
• Knowledge of CPT, ICD‑10, and HCPCS coding systems.
• Strong quantitative and analytical competency.
• Self‑starter with excellent interpersonal communication and problem‑solving skills.